Drugs for ADHD 'not the answer'

Drugs for ADHD 'not the answer'

Joined: April 1st, 2004, 4:56 pm

November 12th, 2007, 10:19 am #1

<TABLE cellSpacing=0 cellPadding=0 width=629 border=0>
<TBODY>
<TR>
<TD colSpan=3>
<DIV class=mxb>

</DIV></TD></TR>
<TR>
<TD vAlign=top width=416><FONT size=2><!-- S BO --><!-- S IIMA -->
<TABLE cellSpacing=0 cellPadding=0 width=203 align=right border=0>
<TBODY>
<TR>
<TD>
<DIV><IMG height=152 alt="Craig Buxton aged 14" hspace=0 src="http://newsimg.bbc.co.uk/media/images/44229000/jpg/_44229996_craig2.jpg" width=203 border=0>
</DIV></TD></TR></TBODY></TABLE><!-- E IIMA --><!-- S SF -->Treating children who have Attention Deficit Hyperactivity Disorder with drugs is not effective in the long-term, research has shown.
A study obtained by the BBC's Panorama programme says drugs such as Ritalin and Concerta work no better than therapy after three years of treatment.
The findings by an influential US study also suggested long-term use of the drugs could stunt children's growth.
It said that the benefits of drugs had previously been exaggerated. <!-- E SF -->
The Multimodal Treatment Study of Children with ADHD has been monitoring the treatment of 600 children across the US since the 1990s.
'Exaggerated impact'
In 1999, it concluded that after one year medication worked better than behavioural therapy for ADHD.
This finding influenced medical practice on both sides of the Atlantic, and prescription rates in the UK have since tripled.
The report's co-author, Professor William Pelham of the University of Buffalo, said: "I think that we exaggerated the beneficial impact of medication in the first study.
"We had thought that children medicated longer would have better outcomes. That didn't happen to be the case.
"The children had a substantial decrease in their rate of growth so they weren't growing as much as other kids both in terms of their height and in terms of their weight.
"And the second was that there were no beneficial effects -none."
Video diary
Panorama said GPs in the UK prescribed ADHD drugs such as Ritalin and Concerta to around 55,000 children last year - at a cost of £28m to the NHS.
The Panorama programme features disturbing footage of a 14-year-old from Stoke-on-Trent, who has been on ADHD medication for a decade.
Craig Buxton's family kept a video diary of his behaviour and captured on camera examples of just how explosive his behaviour can be - he recently assaulted three school teachers.
His mother Sharon said things had gone from bad to worse.
"He has broke down and cried when he gets into situations," she said.
"He says: 'Why am I like this mum, I don't want to feel like this, I don't want to be like this, you know, help me'.
"And all I can do is go back to the doctors and say: 'Is there anything more you can do?'
"All they say is, well, we are doing what we can."
Panorama: What Next for Craig? BBC One 8.30pm, Monday 12 November 2007
</FONT></TD></TR></TBODY></TABLE>
Quote
Like
Share

Joined: April 1st, 2004, 4:56 pm

November 12th, 2007, 10:22 am #2

<TABLE cellSpacing=0 cellPadding=0 width=629 border=0>
<TBODY>
<TR>
<TD colSpan=3>
<DIV class=mxb>
</DIV></TD></TR>
<TR>
<TD vAlign=top width=416><FONT size=2><!-- S BO --><!-- S IBYL -->
<DIV class=mvb>
<TABLE cellSpacing=0 cellPadding=0 width=416 border=0>
<TBODY>
<TR>
<TD vAlign=bottom>
</TD></TR></TBODY></TABLE><IMG height=1 alt="" hspace=0 src="http://newsimg.bbc.co.uk/shared/img/999999.gif" width=416 border=0>
</DIV><!-- E IBYL -->
<!-- S IBOX -->
<TABLE cellSpacing=0 cellPadding=0 width=208 align=right border=0>
<TBODY>
<TR>
<TD width=5><IMG height=1 alt="" hspace=0 src="http://newsimg.bbc.co.uk/shared/img/o.gif" width=5 border=0></TD>
<TD class=sibtbg>

</TD></TR></TBODY></TABLE><!-- E IBOX -->
Most of the estimated half million children in Britain with the behavioural condition Attention Deficit Hyperactivity Disorder (ADHD) receive no treatment at all.

Those that do, tend to be given powerful stimulant medication like Ritalin and Concerta. These drugs can help inattentive and unruly children focus and have been the first choice for doctors treating ADHD over the last decade.

However, stimulant medication is not without its problems.

Similar to amphetamine, it can cause insomnia and suppress the appetite, causing weight loss and stunt growth. There have even been reports of children becoming suicidal on them.

Anxious parents though, have long been reassured by doctors that the benefits of medication far outweigh the risks. Children with ADHD are at an increased risk of delinquency, substance misuse and even of going to jail.

<!-- S IBOX -->
<TABLE cellSpacing=0 cellPadding=0 width=208 align=right border=0>
<TBODY>
<TR>
<TD width=5><IMG height=1 alt="" hspace=0 src="http://newsimg.bbc.co.uk/shared/img/o.gif" width=5 border=0></TD>
<TD class=sibtbg>
<DIV>
</DIV>
<DIV class=mva>
<DIV>Professor William Pelham</DIV></DIV></TD></TR></TBODY></TABLE><!-- E IBOX -->The implication has always been that medication will improve those dire prospects.

But - now that so many children have been on these drugs for years - what scientific evidence is there to support that?

Seven years ago, I filmed with a lively young lad from Stoke-on-Trent who'd recently been diagnosed with ADHD.

Craig Buxton was just four and a half when his mum first agreed - on a child psychiatrist's recommendation - to start him on Ritalin.
She was worried about the side effects even then, but with little other support on offer, she felt it was the only thing she could do to bring some normality to family life.

The psychiatrist's view seemed to be backed up by the findings of the biggest and most influential study ever done on the treatment of children with ADHD that had just been published.

<!-- S IIMA -->
<TABLE cellSpacing=0 cellPadding=0 width=203 align=right border=0>
<TBODY>
<TR>
<TD>
<DIV><IMG height=152 alt="Craig Buxton aged 14" hspace=0 src="http://newsimg.bbc.co.uk/media/images/44229000/jpg/_44229996_craig2.jpg" width=203 border=0>
</DIV></TD></TR></TBODY></TABLE><!-- E IIMA -->As Panorama revealed in 2000, the US-based MTA study compared the treatment of 600 children with ADHD and found that medication was superior to behavioural therapy.

Fast forward to 2007, though, and I discovered that the MTA study group was about to publish some new findings.

They had continued to monitor the 600 children and - after three years - reached a surprising conclusion; medication is actually no better than therapy in the long-term and can stunt children's growth.

MTA co-author, Professor William Pelham, a world authority on ADHD, told Panorama:

"I think that we exaggerated the beneficial impact of medication in the first study. We had thought that children medicated longer would have better outcomes.

"That didn't happen to be the case. There's no indication that medication's better than nothing in the long run."

That prompted me to get back in touch with Craig Buxton's mum, Sharon, to find out what has happened since we last met.

It turns out things have gone from bad to worse for Craig, despite having remained on medication for the best part of a decade.

He has no friends, has self-harmed, suffers night terrors, is aggressive and - after assaulting three school teachers - prison looks like a very real prospect if the family don't get the help they're crying out for.

The good news is that the National Institute for Clinical Excellence is currently revising the treatment guidelines for ADHD. Chair of the working group, Dr Tim Kendall says:

"I hope that we will be able to make recommendations that will give people, based on the best evidence we've got, a comprehensive approach to treatment which will advise about the use of parent training programmes, the use of behavioural interventions.

"The important thing is that we have an approach which doesn't focus just on one type of treatment."

Panorama: What Next for Craig? BBC One 8.30pm, Monday 12 November 2007 <!-- E BO --></FONT>
<BR clear=all></TD></TR></TBODY></TABLE>
Quote
Like
Share

Joined: April 1st, 2004, 4:56 pm

November 12th, 2007, 10:29 am #3

<!-- small_banner -->&nbsp;
<TABLE class=small_banner_color cellSpacing=0 cellPadding=5 width="100%" border=0>
<TBODY>
<TR>
<TD noWrap align=left><IMG alt=ClinicalTrials.gov src="http://clinicaltrials.gov/ct2/html/images/frame/small_title.gif" border=0> </TD>
<TD noWrap align=right>
<TABLE cellSpacing=0 cellPadding=1 border=0>
<TBODY>
<TR>
<TD class=header3 noWrap>&nbsp;<A title="Show Home Page" href="http://clinicaltrials.gov/ct2/home">Home</A> &nbsp; </TD>
<TD class=header3 noWrap>&nbsp;<A title="Show Search Page" href="http://clinicaltrials.gov/ct2/search">Search</A> &nbsp; </TD>
<TD class=header3 noWrap>&nbsp;<A title="Show Study Topics Page" href="http://clinicaltrials.gov/ct2/search/browse">Study Topics</A> &nbsp; </TD>
<TD class=header3 noWrap>&nbsp;<A title="Show Glossary Page" href="http://clinicaltrials.gov/ct2/info/glossary">Glossary</A> &nbsp; </TD></TR></TBODY></TABLE>
<FORM style="MARGIN-TOP: 0.5ex; MARGIN-BOTTOM: 0.5ex" name=search action=/ct2/results method=get><SPAN class=body3><INPUT class=body3 alt="Search Terms" maxLength=250 size=30 name=term> <INPUT class=header3 type=submit alt=Search value=Search> &nbsp; </SPAN></FORM></TD></TR></TBODY></TABLE>
<TABLE cellSpacing=0 cellPadding=0 width="100%" border=0>
<TBODY>
<TR>
<TD><IMG height=3 alt="" src="http://clinicaltrials.gov/ct2/html/images/frame/bar.gif" width="100%"></TD></TR></TBODY></TABLE><!-- above_tabs -->
<!-- tabs -->
<TABLE class=show_back_color cellSpacing=0 cellPadding=0 border=0>
<TBODY>
<TR>
<TD vAlign=bottom width=20><IMG style="WIDTH: 20px; HEIGHT: 2px" alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/top.gif"></TD>
<TD vAlign=bottom><IMG style="WIDTH: 6px; HEIGHT: 2px" alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/top.gif"></TD>
<TD vAlign=bottom><IMG style="WIDTH: 15px; HEIGHT: 2px" alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/top.gif"></TD>
<TD vAlign=bottom><IMG style="WIDTH: 6px; HEIGHT: 2px" alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/top.gif"></TD>
<TD>
<TABLE cellSpacing=0 cellPadding=0 bgColor=white border=0>
<TBODY>
<TR>
<TD class=show_back_color><IMG alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/upper_left_fore.gif"></TD>
<TD vAlign=top><IMG style="WIDTH: 100%; HEIGHT: 2px" alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/top.gif"></TD>
<TD class=show_back_color><IMG alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/upper_right_fore.gif"></TD></TR>
<TR>
<TD align=left><IMG style="WIDTH: 2px; HEIGHT: 3ex" alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/left.gif"></TD>
<TD class=header3 vAlign=top noWrap>&nbsp; Full Text View &nbsp; </TD>
<TD align=right><IMG style="WIDTH: 3px; HEIGHT: 3ex" alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/right.gif"></TD></TR>
<TR>
<TD align=left><IMG height=2 alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/top.gif" width=1></TD>
<TD class=spacer>
<TD align=right><IMG height=2 alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/top.gif" width=2></TD></TR></TBODY></TABLE></TD>
<TD vAlign=bottom><IMG style="WIDTH: 6px; HEIGHT: 2px" alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/top.gif"></TD>
<TD>
<TABLE class=back_tab_color cellSpacing=0 cellPadding=0 border=0>
<TBODY>
<TR>
<TD class=show_back_color><IMG alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/upper_left_back.gif"></TD>
<TD vAlign=top><IMG style="WIDTH: 100%; HEIGHT: 2px" alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/top.gif"></TD>
<TD class=show_back_color><IMG alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/upper_right_back.gif"></TD></TR>
<TR>
<TD align=left><IMG style="WIDTH: 2px; HEIGHT: 3ex" alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/left.gif"></TD>
<TD class=header3 vAlign=top noWrap>&nbsp; <A title="Show Tabular View Page" href="http://clinicaltrials.gov/ct2/show/record/NCT00000388">Tabular View</A> &nbsp; </TD>
<TD align=right><IMG style="WIDTH: 3px; HEIGHT: 3ex" alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/right.gif"></TD></TR>
<TR>
<TD vAlign=top colSpan=3><IMG height=2 alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/top.gif" width="100%"></TD></TR></TBODY></TABLE></TD>
<TD vAlign=bottom><IMG style="WIDTH: 6px; HEIGHT: 2px" alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/top.gif"></TD>
<TD>
<TABLE class=back_tab_color cellSpacing=0 cellPadding=0 border=0>
<TBODY>
<TR>
<TD class=show_back_color><IMG alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/upper_left_back.gif"></TD>
<TD vAlign=top><IMG style="WIDTH: 100%; HEIGHT: 2px" alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/top.gif"></TD>
<TD class=show_back_color><IMG alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/upper_right_back.gif"></TD></TR>
<TR>
<TD align=left><IMG style="WIDTH: 2px; HEIGHT: 3ex" alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/left.gif"></TD>
<TD class=header3 vAlign=top noWrap>&nbsp; <A title="Show Contacts and Locations Page" href="http://clinicaltrials.gov/ct2/show/locn/NCT00000388">Contacts and Locations</A> &nbsp; </TD>
<TD align=right><IMG style="WIDTH: 3px; HEIGHT: 3ex" alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/right.gif"></TD></TR>
<TR>
<TD vAlign=top colSpan=3><IMG height=2 alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/top.gif" width="100%"></TD></TR></TBODY></TABLE></TD>
<TD vAlign=bottom><IMG style="WIDTH: 6px; HEIGHT: 2px" alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/top.gif"></TD>
<TD vAlign=bottom><IMG style="WIDTH: 20px; HEIGHT: 2px" alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/top.gif"></TD>
<TD vAlign=bottom><IMG style="WIDTH: 6px; HEIGHT: 2px" alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/top.gif"></TD>
<TD>
<TABLE class=back_tab_color cellSpacing=0 cellPadding=0 border=0>
<TBODY>
<TR>
<TD class=show_back_color><IMG alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/upper_left_back.gif"></TD>
<TD vAlign=top><IMG style="WIDTH: 100%; HEIGHT: 2px" alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/top.gif"></TD>
<TD class=show_back_color><IMG alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/upper_right_back.gif"></TD></TR>
<TR>
<TD align=left><IMG style="WIDTH: 2px; HEIGHT: 3ex" alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/left.gif"></TD>
<TD class=header3 vAlign=top noWrap>&nbsp; <A title="Show Related Studies Page" href="http://clinicaltrials.gov/ct2/show/related/NCT00000388">Related Studies</A> &nbsp; </TD>
<TD align=right><IMG style="WIDTH: 3px; HEIGHT: 3ex" alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/right.gif"></TD></TR>
<TR>
<TD vAlign=top colSpan=3><IMG height=2 alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/top.gif" width="100%"></TD></TR></TBODY></TABLE></TD>
<TD vAlign=bottom width="100%"><IMG style="WIDTH: 100%; HEIGHT: 2px" alt="" src="http://clinicaltrials.gov/ct2/html/images/tabs/top.gif"></TD></TR></TBODY></TABLE><!-- Title section -->
<DIV class=indent3>
<CENTER style="MARGIN-TOP: 3ex"><SPAN class=header1>Multimodal Treatment Study of Children With Attention Deficit and Hyperactivity Disorder (ADHD)</SPAN>

<SPAN class=header2 style="COLOR: red">This study has been completed.</SPAN>


<TABLE cellSpacing=0 cellPadding=5 width="50%" border=1>
<TBODY>
<TR>
<TD class=header3 style="BACKGROUND-COLOR: #eeeeff" noWrap align=right>Sponsored by: </TD>
<TD class=body2 noWrap align=left><A onclick="openNewWindow('/ct2/bye/1QoPWw4lZX-i-iSxuQ7LlXNxeQYxUd-B.'); return false" href="http://clinicaltrials.gov/ct2/bye/1QoPWw4lZX-i-iSxuQ7LlXNxeQYxUd-B.">National Institute of Mental Health (NIMH)</A>
</TD></TR>
<TR>
<TD class=header3 style="BACKGROUND-COLOR: #eeeeff" noWrap align=right>Information provided by:</TD>
<TD class=body2 noWrap align=left>National Institute of Mental Health (NIMH)</TD></TR>
<TR>
<TD class=header3 style="BACKGROUND-COLOR: #eeeeff" noWrap align=right>ClinicalTrials.gov Identifier:</TD>
<TD class=body2 noWrap align=left>NCT00000388</TD></TR></TBODY></TABLE></CENTER></DIV><!-- purpose_section -->
<DIV class=indent1 style="BORDER-RIGHT: white 1px solid; BORDER-TOP: white 1px solid; MARGIN-TOP: 3ex; BORDER-LEFT: white 1px solid; BORDER-BOTTOM: white 1px solid"><IMG alt="" src="http://clinicaltrials.gov/ct2/html/images/frame/triangle.gif"><SPAN class=header2>&nbsp; Purpose</SPAN>
<DIV class=indent2 style="MARGIN-TOP: 2ex">
<DIV class=body3>
<P style="MARGIN-BOTTOM: 1ex">This trial is a continuation of the Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (MTA Study). Continuation Aim 1 is to track the persistence of intervention-related effects as the MTA sample matures into mid-adolescence, including subsequent mental-health and school-related service utilization patterns as a function of MTA treatment experience (treatment assignment) and outcome (degree of treatment success at 14 mo.). Aim 2 is to test specific hypotheses about predictors, mediators, and moderators of long-term outcome among children with ADHD (e.g., comorbidity; family functioning; cognitive skills; peer relations) that may influence adolescent functioning (either independent of or through initial treatment assignment and/or 14-month treatment outcomes); and to compare how these predictors, mediators, and moderators are similar or dissimilar within the normal comparison group. Aim 3 is to track the patterns of risk and protective factors (including their mediation or moderation by initial treatment assignment and/or outcome) involved in early and subsequent stages of developing substance-related disorders and antisocial behavior. Aim 4 is to examine the effect of initial treatment assignment and degree of treatment success on later academic performance, achievement, school conduct, tendency to drop out, and other adverse school outcomes.

<P style="MARGIN-BOTTOM: 1ex">In the original MTA design, patients were randomly assigned to 1 of 4 treatment conditions: (1) medication only; (2) psychosocial only; (3) combined (medication and psychosocial); or (4) Assessment-and-Referral condition. All but the latter were treated intensively for 14 months, with assessments for all subjects at baseline, 3, 9, 14, and 24 months. The original MTA design thus provides short-term (10 months post-treatment) follow-up at 24 months. This continuation extends the follow-up to assessments at 36, 60, and 84 months after treatment.

<P style="MARGIN-BOTTOM: 1ex">A child may be eligible for this study if he/she:

<P style="MARGIN-BOTTOM: 1ex">Is 7 - 9 years old, and has Attention Deficit Hyperactivity Disorder (ADHD).
</DIV>
<!-- condition, intervention, phase summary table -->
<TABLE cellSpacing=0 cellPadding=5 width="80%" border=1>
<TBODY>
<TR align=left>
<TD class=header3 style="BACKGROUND-COLOR: #eeeeff"><A onclick="openPopupWindow('/ct2/help/conditions_desc',false); return false;" href="http://clinicaltrials.gov/ct2/help/conditions_desc">Condition</A> </TD>
<TD class=header3 style="BACKGROUND-COLOR: #eeeeff"><A onclick="openPopupWindow('/ct2/help/interventions_desc',false); return false;" href="http://clinicaltrials.gov/ct2/help/interventions_desc">Intervention</A> </TD>
<TD class=header3 style="BACKGROUND-COLOR: #eeeeff"><A onclick="openPopupWindow('/ct2/help/phase_desc',false); return false;" href="http://clinicaltrials.gov/ct2/help/phase_desc">Phase</A> </TD></TR>
<TR vAlign=top align=left>
<TD class=body3 noWrap>Attention Deficit Disorder With Hyperactivity
Substance-Related Disorders
Dyssocial Behavior
</TD>
<TD class=body3 noWrap>Behavioral: Psychosocial treatment
Drug: Anti-ADHD medication
Behavioral: Assessment-and-Referral
</TD>
<TD class=body3 noWrap>Phase IV
</TD></TR></TBODY></TABLE>
<!-- medline links -->
<TABLE cellSpacing=0 cellPadding=0 border=0>
<TBODY>
<TR>
<TD class=body3 vAlign=top noWrap><A onclick="openNewWindow('http://www.nlm.nih.gov/medlineplus/'); return false" href="http://www.nlm.nih.gov/medlineplus/">MedlinePlus</A> related topics: &nbsp; </TD>
<TD class=body3 vAlign=top><A onclick="openNewWindow('/ct2/bye/gQoPWw4lZX-i-iSxudhWudNzlXNiZip9m67PvQ7xzwhaLwS9kioPzdUPedcx5676eBczWQozE61ykB-PeiNzWT7Pewc9S6hHSXNkWd7E.'); return false" href="http://clinicaltrials.gov/ct2/bye/gQoPWw4lZX-i-iSxudhWudNzlXNiZip9m67PvQ7xzwhaLwS9kioPzdUPedcx5676eBczWQozE61ykB-PeiNzWT7Pewc9S6hHSXNkWd7E.">Attention Deficit Hyperactivity Disorder</A> &nbsp; <A onclick="openNewWindow('/ct2/bye/aQoPWw4lZX-i-iSxudhWudNzlXNiZip9m67PvQ7xzwhaLwS95wUHUB7yLwc8uQoPmdt.'); return false" href="http://clinicaltrials.gov/ct2/bye/aQoPWw4lZX-i-iSxudhWudNzlXNiZip9m67PvQ7xzwhaLwS95wUHUB7yLwc8uQoPmdt.">Drug Abuse</A> &nbsp; <A onclick="openNewWindow('/ct2/bye/qQoPWw4lZX-i-iSxudhWudNzlXNiZip9m67PvQ7xzwhaLwS9E61yFdcxkdhzWT7Pewc9S6hHSwSxlihLv.'); return false" href="http://clinicaltrials.gov/ct2/bye/qQoPWw4lZX-i-iSxudhWudNzlXNiZip9m67PvQ7xzwhaLwS9E61yFdcxkdhzWT7Pewc9S6hHSwSxlihLv.">Personality Disorders</A> &nbsp; </TD></TR></TBODY></TABLE>

<TABLE cellSpacing=0 cellPadding=0 border=0>
<TBODY>
<TR>
<TD class=body3 vAlign=top noWrap>Study Type: &nbsp;</TD>
<TD class=body3 vAlign=top>Interventional</TD></TR>
<TR>
<TD class=body3 vAlign=top noWrap>Study Design: &nbsp;</TD>
<TD class=body3 vAlign=top>Treatment, Randomized</TD></TR>
<TR class=spacer>
<TD></TD>
<TR>
<TD class=body3 vAlign=top noWrap>Official Title: &nbsp;</TD>
<TD class=body3 vAlign=top>Multimodal Treatment Study of Children With ADHD</TD></TR></TBODY></TABLE><!-- more details -->



<DIV class=indent3>
<TABLE cellSpacing=0 cellPadding=0 border=0>
<TBODY>
<TR>
<TD class=body3 vAlign=top noWrap>Start Date: &nbsp;</TD>
<TD class=body3 vAlign=top>September 1998</TD></TR>
<TR>
<TD class=body3 vAlign=top noWrap>Completion Date: &nbsp;</TD>
<TD class=body3 vAlign=top>November 1999</TD></TR></TBODY></TABLE>
<A id=desc name=desc></A><!-- detailed description --><SPAN class=header3>Detailed Description:</SPAN>
<DIV class=body3>
<P style="MARGIN-BOTTOM: 1ex">This trial is a continuation of the Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (MTA Study). Continuation Aim 1 is to track the persistence of intervention-related effects as the MTA sample matures into mid-adolescence, including subsequent mental-health and school-related service utilization patterns as a function of MTA treatment experience (treatment assignment) and outcome (degree of treatment success at 14 mo.). Aim 2 is to test specific hypotheses about predictors, mediators, and moderators of long-term outcome among children with ADHD (e.g., comorbidity; family functioning; cognitive skills; peer relations) that may influence adolescent functioning (either independent of or through initial treatment assignment and/or 14-month treatment outcomes); and to compare how these predictors, mediators, and moderators are similar or dissimilar within the normal comparison group. Aim 3 is to track the patterns of risk and protective factors (including their mediation or moderation by initial treatment assignment and/or outcome) involved in early and subsequent stages of developing substance-related disorders and antisocial behavior. Aim 4 is to examine the effect of initial treatment assignment and degree of treatment success on later academic performance, achievement, school conduct, tendency to drop out, and other adverse school outcomes.

<P style="MARGIN-BOTTOM: 1ex">In the original MTA design, patients were randomly assigned to 1 of 4 treatment conditions: (1) medication only; (2) psychosocial only; (3) combined (medication and psychosocial); or (4) Assessment-and-Referral condition. All but the latter were treated intensively for 14 months, with assessments for all subjects at baseline, 3, 9, 14, and 24 months. The original MTA design thus provides short-term (10 months post-treatment) follow-up at 24 months. This continuation extends the follow-up to assessments at 36, 60, and 84 months after treatment.
</DIV></DIV></DIV></DIV><!-- eligibility_section -->
<DIV class=indent1 style="BORDER-RIGHT: white 1px solid; BORDER-TOP: white 1px solid; MARGIN-TOP: 3ex; BORDER-LEFT: white 1px solid; BORDER-BOTTOM: white 1px solid"><IMG alt="" src="http://clinicaltrials.gov/ct2/html/images/frame/triangle.gif"><SPAN class=header2>&nbsp; Eligibility</SPAN>
<DIV class=indent2 style="MARGIN-TOP: 2ex">
<TABLE cellSpacing=0 cellPadding=0 border=0>
<TBODY>
<TR>
<TD class=body3 noWrap>Ages Eligible for Study: &nbsp; </TD>
<TD class=body3>7 Years to 9 Years</TD></TR>
<TR>
<TD class=body3 noWrap>Genders Eligible for Study: &nbsp; </TD>
<TD class=body3>Both</TD></TR></TBODY></TABLE>
<SPAN class=header3>Criteria</SPAN>

<DIV class=indent3>
<DIV class=body3>
<P style="MARGIN-BOTTOM: 1ex">Inclusion Criteria:

<P style="MARGIN-BOTTOM: 1ex">-

<P style="MARGIN-BOTTOM: 1ex">Patients must have:

<P style="MARGIN-BOTTOM: 1ex">Rigorously diagnosed Attention Deficit Hyperactivity Disorder (ADHD).
</DIV></DIV></DIV></DIV><!-- location_section -->
<DIV class=indent1 style="BORDER-RIGHT: white 1px solid; BORDER-TOP: white 1px solid; MARGIN-TOP: 3ex; BORDER-LEFT: white 1px solid; BORDER-BOTTOM: white 1px solid"><IMG alt="" src="http://clinicaltrials.gov/ct2/html/images/frame/triangle.gif"><SPAN class=header2>&nbsp; Contacts and Locations</SPAN>


<DIV class=indent2><SPAN class=body3>Please refer to this study by its ClinicalTrials.gov identifier: NCT00000388</SPAN>
<!-- contacts --><!-- locations --><A id=locn name=locn></A><!-- sponsors -->
<SPAN class=header3>Sponsors and Collaborators</SPAN>

<DIV class=indent1>
<TABLE cellSpacing=0 cellPadding=0 border=0>
<TBODY>
<TR class=spacer>
<TD></TD>
<TR>
<TD class=body3 noWrap><A onclick="openNewWindow('/ct2/bye/1QoPWw4lZX-i-iSxuQ7LlXNxeQYxUd-B.'); return false" href="http://clinicaltrials.gov/ct2/bye/1QoPWw4lZX-i-iSxuQ7LlXNxeQYxUd-B.">National Institute of Mental Health (NIMH)</A></TD></TR></TBODY></TABLE></DIV><!-- investigators -->
<SPAN class=header3>Investigators</SPAN>

<DIV class=indent1>
<TABLE cellSpacing=0 cellPadding=2 border=0>
<TBODY>
<TR class=spacer>
<TD></TD>
<TR>
<TD class=body3 noWrap>Principal Investigator: &nbsp; &nbsp; </TD>
<TD class=body3 noWrap>Howard B. Abikoff, PhD &nbsp; &nbsp; </TD>
<TD></TD>
<TR class=spacer>
<TD></TD>
<TR>
<TD class=body3 noWrap>Principal Investigator: &nbsp; &nbsp; </TD>
<TD class=body3 noWrap>C. Keith Conners &nbsp; &nbsp; </TD>
<TD></TD>
<TR class=spacer>
<TD></TD>
<TR>
<TD class=body3 noWrap>Principal Investigator: &nbsp; &nbsp; </TD>
<TD class=body3 noWrap>Laurence L. Greenhill, MD &nbsp; &nbsp; </TD>
<TD></TD>
<TR class=spacer>
<TD></TD>
<TR>
<TD class=body3 noWrap>Principal Investigator: &nbsp; &nbsp; </TD>
<TD class=body3 noWrap>Stephen P. Hinshaw, PhD &nbsp; &nbsp; </TD>
<TD></TD>
<TR class=spacer>
<TD></TD>
<TR>
<TD class=body3 noWrap>Principal Investigator: &nbsp; &nbsp; </TD>
<TD class=body3 noWrap>William E. Pelham, PhD &nbsp; &nbsp; </TD>
<TD></TD>
<TR class=spacer>
<TD></TD>
<TR>
<TD class=body3 noWrap>Principal Investigator: &nbsp; &nbsp; </TD>
<TD class=body3 noWrap>James M. Swanson, PhD &nbsp; &nbsp; </TD>
<TD></TD></TR></TBODY></TABLE></DIV></DIV></DIV><!-- more_info_section -->
<DIV class=indent1 style="BORDER-RIGHT: white 1px solid; BORDER-TOP: white 1px solid; MARGIN-TOP: 3ex; BORDER-LEFT: white 1px solid; BORDER-BOTTOM: white 1px solid"><IMG alt="" src="http://clinicaltrials.gov/ct2/html/images/frame/triangle.gif"><SPAN class=header2>&nbsp; More Information</SPAN>
<DIV class=indent2>
<SPAN class=body3>Publications of Results:</SPAN>

<DIV class=indent2 style="MARGIN-TOP: 1.5ex">
<TABLE cellSpacing=0 cellPadding=0 width="100%" border=0>
<TBODY>
<TR>
<TD class=body3><A onclick="openNewWindow('/ct2/bye/zQoPWw4lZX-i-iSxuBcyeXNxvdDxuQ7Ju6c9cXcHuioyzTp9ai7HSTDxNBciescgm64LD61PSQ7Hc6D65B0LVi7yg67VN6h9Ei4L3BUgWwNG0iY6vQ1gW1-He6oR9RCtLKCjSK4R.'); return false" href="http://clinicaltrials.gov/ct2/bye/zQoPWw4lZX-i-iSxuBcyeXNxvdDxuQ7Ju6c9cXcHuioyzTp9ai7HSTDxNBciescgm64LD61PSQ7Hc6D65B0LVi7yg67VN6h9Ei4L3BUgWwNG0iY6vQ1gW1-He6oR9RCtLKCjSK4R.">[No authors listed] A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD. Arch Gen Psychiatry. 1999 Dec;56(12):1073-86.</A>
&nbsp; </TD></TR></TBODY></TABLE></DIV>
<TABLE cellSpacing=0 cellPadding=0 border=0>
<TBODY>
<TR>
<TD class=body3 noWrap>Study ID Numbers: &nbsp; </TD>
<TD class=body3>MH50453, MH50447, MH50454, MH50461, MH50467, MH50440</TD></TR>
<TR>
<TD class=body3 noWrap>First Received: &nbsp; </TD>
<TD class=body3>November 2, 1999</TD></TR>
<TR>
<TD class=body3 noWrap>Last Updated: &nbsp; </TD>
<TD class=body3>November 18, 2005</TD></TR>
<TR>
<TD class=body3 noWrap>ClinicalTrials.gov Identifier: &nbsp; </TD>
<TD class=body3>NCT00000388</TD></TR>
<TR>
<TD class=body3 noWrap>Health Authority: &nbsp; </TD>
<TD class=body3>United States: Federal Government</TD></TR></TBODY></TABLE><!-- keywords -->

<DIV class=body3>Keywords provided by National Institute of Mental Health (NIMH):
<DIV class=indent3>
<TABLE cellSpacing=0 cellPadding=0 width="100%">
<TBODY>
<TR vAlign=top>
<TD width="50%">
<TABLE cellSpacing=0 cellPadding=0>
<TBODY>
<TR>
<TD noWrap><SPAN class=body3>Attention Deficit Disorder with Hyperactivity &nbsp; </SPAN></TD></TR>
<TR>
<TD noWrap><SPAN class=body3>Adolescence &nbsp; </SPAN></TD></TR>
<TR>
<TD noWrap><SPAN class=body3>Child &nbsp; </SPAN></TD></TR>
<TR>
<TD noWrap><SPAN class=body3>Cognition &nbsp; </SPAN></TD></TR>
<TR>
<TD noWrap><SPAN class=body3>Combined Modality Therapy &nbsp; </SPAN></TD></TR>
<TR>
<TD noWrap><SPAN class=body3>Female &nbsp; </SPAN></TD></TR>
<TR>
<TD noWrap><SPAN class=body3>Human &nbsp; </SPAN></TD></TR></TBODY></TABLE></TD>
<TD class=spacer>
<TD width="50%">
<TABLE cellSpacing=0 cellPadding=0>
<TBODY>
<TR>
<TD noWrap><SPAN class=body3>Male</SPAN></TD></TR>
<TR>
<TD noWrap><SPAN class=body3>Peer Group</SPAN></TD></TR>
<TR>
<TD noWrap><SPAN class=body3>Risk Factors</SPAN></TD></TR>
<TR>
<TD noWrap><SPAN class=body3>Treatment Outcome</SPAN></TD></TR>
<TR>
<TD noWrap><SPAN class=body3>Attention Deficit Disorder with Hyperactivity -- *therapy</SPAN></TD></TR>
<TR>
<TD noWrap><SPAN class=body3>Attention Deficit Disorder with Hyperactivity -- drug therapy</SPAN></TD></TR>
<TR>
<TD noWrap><SPAN class=body3>Attention Deficit Disorder with Hyperactivity -- psychology</SPAN></TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></DIV></DIV><!-- browse terms -->

<DIV class=body3>Study placed in the following topic categories:
<DIV class=indent3>
<TABLE cellSpacing=0 cellPadding=0 width="100%">
<TBODY>
<TR vAlign=top>
<TD width="50%">
<TABLE cellSpacing=0 cellPadding=0>
<TBODY>
<TR>
<TD noWrap><SPAN class=body3>Signs and Symptoms</SPAN></TD></TR>
<TR>
<TD noWrap><SPAN class=body3>Attention Deficit Disorder with Hyperactivity</SPAN></TD></TR>
<TR>
<TD noWrap><SPAN class=body3>Mental Disorders Diagnosed in Childhood</SPAN></TD></TR>
<TR>
<TD noWrap><SPAN class=body3>Substance-Related Disorders</SPAN></TD></TR>
<TR>
<TD noWrap><SPAN class=body3>Neurologic Manifestations</SPAN></TD></TR>
<TR>
<TD noWrap><SPAN class=body3>Attention Deficit and Disruptive Behavior Disorders</SPAN></TD></TR></TBODY></TABLE></TD>
<TD class=spacer>
<TD width="50%">
<TABLE cellSpacing=0 cellPadding=0>
<TBODY>
<TR>
<TD noWrap><SPAN class=body3>Hyperkinesis</SPAN></TD></TR>
<TR>
<TD noWrap><SPAN class=body3>Antisocial personality disorder</SPAN></TD></TR>
<TR>
<TD noWrap><SPAN class=body3>Antisocial Personality Disorder</SPAN></TD></TR>
<TR>
<TD noWrap><SPAN class=body3>Dyskinesias</SPAN></TD></TR>
<TR>
<TD noWrap><SPAN class=body3>Personality Disorders</SPAN></TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></DIV></DIV><!-- mesh terms -->

<DIV class=body3>Additional relevant MeSH terms:
<DIV class=indent3>
<TABLE cellSpacing=0 cellPadding=0 width="100%">
<TBODY>
<TR vAlign=top>
<TD width="50%">
<TABLE cellSpacing=0 cellPadding=0>
<TBODY>
<TR>
<TD noWrap><SPAN class=body3>Mental Disorders</SPAN></TD></TR>
<TR>
<TD noWrap><SPAN class=body3>Nervous System Diseases</SPAN></TD></TR>
<TR>
<TD noWrap><SPAN class=body3>Disorders of Environmental Origin</SPAN></TD></TR>
<TR>
<TD noWrap><SPAN class=body3>Pathological Conditions, Signs and Symptoms</SPAN></TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></DIV></DIV>
<SPAN class=body3>ClinicalTrials.gov processed this record on November 09, 2007</SPAN>

</DIV></DIV><!-- Footer -->
<TABLE cellSpacing=0 cellPadding=0 width="100%" border=0>
<TBODY>
<TR>
<TD><IMG height=3 alt="" src="http://clinicaltrials.gov/ct2/html/images/frame/bar.gif" width="100%"></TD></TR></TBODY></TABLE> <!-- 2007:11:12 05:26:53.978 &nbsp; 170879 &nbsp; EXT_ZUKAQD:0 &nbsp; PWUXEG:0 -->
<SCRIPT language=JavaScript>
<!--
var SymRealOnLoad;
var SymRealOnUnload;

function SymOnUnload()
{
window.open = SymWinOpen;
if(SymRealOnUnload != null)
SymRealOnUnload();
}

function SymOnLoad()
{
if(SymRealOnLoad != null)
SymRealOnLoad();
window.open = SymRealWinOpen;
SymRealOnUnload = window.onunload;
window.onunload = SymOnUnload;
}

SymRealOnLoad = window.onload;
window.onload = SymOnLoad;

//-->
</SCRIPT>
Quote
Like
Share

Joined: April 1st, 2004, 4:56 pm

November 12th, 2007, 10:34 am #4

<TABLE cellSpacing=0 cellPadding=0 width=629 border=0>
<TBODY>
<TR>
<TD colSpan=3>
<DIV class=mxb>

</DIV></TD></TR>
<TR>
<TD vAlign=top width=416><FONT size=2><!-- S BO --><!-- S IIMA -->
<TABLE cellSpacing=0 cellPadding=0 width=203 align=right border=0>
<TBODY>
<TR>
<TD>
<DIV><IMG height=152 alt="Craig Buxton aged 14" hspace=0 src="http://newsimg.bbc.co.uk/media/images/44229000/jpg/_44229996_craig2.jpg" width=203 border=0>
</DIV></TD></TR></TBODY></TABLE><!-- E IIMA --><!-- S SF -->Treating children who have Attention Deficit Hyperactivity Disorder with drugs is not effective in the long-term, research has shown.
A study obtained by the BBC's Panorama programme says drugs such as Ritalin and Concerta work no better than therapy after three years of treatment.
The findings by an influential US study also suggested long-term use of the drugs could stunt children's growth.
It said that the benefits of drugs had previously been exaggerated. <!-- E SF -->
The Multimodal Treatment Study of Children with ADHD has been monitoring the treatment of 600 children across the US since the 1990s.
'Exaggerated impact'
In 1999, it concluded that after one year medication worked better than behavioural therapy for ADHD.
This finding influenced medical practice on both sides of the Atlantic, and prescription rates in the UK have since tripled.
The report's co-author, Professor William Pelham of the University of Buffalo, said: "I think that we exaggerated the beneficial impact of medication in the first study.
"We had thought that children medicated longer would have better outcomes. That didn't happen to be the case.
"The children had a substantial decrease in their rate of growth so they weren't growing as much as other kids both in terms of their height and in terms of their weight.
"And the second was that there were no beneficial effects -none."
Video diary
Panorama said GPs in the UK prescribed ADHD drugs such as Ritalin and Concerta to around 55,000 children last year - at a cost of £28m to the NHS.
The Panorama programme features disturbing footage of a 14-year-old from Stoke-on-Trent, who has been on ADHD medication for a decade.
Craig Buxton's family kept a video diary of his behaviour and captured on camera examples of just how explosive his behaviour can be - he recently assaulted three school teachers.
His mother Sharon said things had gone from bad to worse.
"He has broke down and cried when he gets into situations," she said.
"He says: 'Why am I like this mum, I don't want to feel like this, I don't want to be like this, you know, help me'.
"And all I can do is go back to the doctors and say: 'Is there anything more you can do?'
"All they say is, well, we are doing what we can."
Panorama: What Next for Craig? BBC One 8.30pm, Monday 12 November 2007
</FONT></TD></TR></TBODY></TABLE>
<P class=standfirst><STRONG style="DISPLAY: block">DRUGS used to treat attention deficit hyperactivity disorder (ADHD) have no long term effectiveness and could stunt your child's growth.</STRONG>

And scientists have conceded that test results that prompted the parental craze to dole out the drugs to their kids, may have been exaggerated.

In what is sure to generate debate, BBC's Panorama program last night aired the results of an influential long-term monitoring program of 600 children across the US since the early 1990s.

The Multimodal Treatment Study of Children with ADHD study concluded that while drugs such as Ritalin and Concerta worked in the short term, there was no demonstrable improvement in children's behaviour after three years of medication.

In Australia, the use of the prescription drug has been treated by some as a panacea for disruptive behaviour by their children. The popularity of ADHD drugs all but doubled during the past few years and had caused medical authorities some concern.

Eight years ago, studies found one year of medication worked better than behavioural therapy in a finding that influences medical practice.

Bur the report's co-author from the University of Buffalo, Professor William Pelham, said he now believed the findings were overstated.

"I think that we exaggerated the beneficial impact of medication in the first study," he said yesterday. "We had thought that children medicated longer would have better outcomes. That didn't happen to be the case.

"The children had a substantial decrease in their rate of growth so they weren't growing as much as other kids both in terms of their height and in terms of their weight. And the second was that there were no beneficial effects - none.

"In the short run (medication) will help the child behave better, in the long run it won't. And that information should be made very clear to parents."

The influential BBC Panorama television program found last year the cost of ADHD drugs had cost the public health system in Britain more than $AUD60 million.

The program aired disturbing footage of a 14-year-old Briton who had been on ADHD medication for a decade. His family kept a video diary of his behaviour; he recently assaulted three school teachers.

Dr Tim Kendall, of the Royal College of Psychiatrists said: "A generous understanding would be to say that doctors have reached the point where they don't know what else to offer.

"I hope that we will be able to make recommendations that will give people a comprehensive approach to treatment which will advise about what teachers might be able to do within the classroom when they're trying to deal with kids who have difficult problems of this kind."

Prof Pelham believes behavioural therapy such as concentration tests in the first instance and a simple diet of Omega-3 helped.
Quote
Like
Share

Joined: April 1st, 2004, 4:56 pm

November 12th, 2007, 10:41 am #5


Dr Tim Kendall, of the Royal College of Psychiatrists said: "A generous understanding would be to say that doctors have reached the point where they don't know what else to offer.

"I hope that we will be able to make recommendations that will give people a comprehensive approach to treatment which will advise about what teachers might be able to do within the classroom when they're trying to deal with kids who have difficult problems of this kind."

&nbsp;

http://www.news.com.au/dailytelegraph/s ... 07,00.html
Quote
Like
Share

Joined: April 1st, 2004, 4:56 pm

November 12th, 2007, 10:42 am #6

<H1 class=article>Danger drugs designed for schizophrenics used to calm children </H1>11.11.07
<A class=readerComments href="http://www.thisislondon.co.uk/news/article-23420504-details/Danger%20drugs%20designed%20for%20schizophrenics%20used%20to%20calm%20children/article.do#readerComments"><SPAN>&nbsp;</SPAN>Add your view</A>


<DIV id=rhs><IMG height=359 alt="&#10; little boy&#10; " src="http://img.dailymail.co.uk//i/pix/2007/11_02/kidDM1111_228x359.jpg" width=228>
<P class=caption>Mischief making: But some GPs prescribe powerful tranquilisers (posed by model)
</DIV>
Thousands of children with behavioural problems are being prescribed anti-psychotic drugs with dangerous side effects, doctors warn.

The powerful tranquillisers, designed to treat psychosis and schizophrenia in adults, are being used to calm children who are simply hyperactive.

Around 8,000 youngsters are taking anti- psychotics such as Risperdal and Zyprexa despite the fact that these have been linked to a host of health problems from diabetes to brain damage, BBC1's Panorama reports.

Although some are prescribed for schizophrenia and related conditions, many are given to children with attention deficit hyperactivity disorder and other behavioural problems.

Dr Tim Kendall, of the Royal College of Psychiatrists, said he knew of children as young as ten being given the schizophrenia drugs for unruly behaviour, sometimes for as long as five years.

He said that the drugs should be considered as a last resort in the treatment of hyperactivity.

And he added: "A generous understanding would be to say that doctors have reached a point where they don't know what else to offer and they haven't got the right supports to help parents in difficult circumstances.

"I think perhaps there is no real excuse for prescribing drugs which are associated with such severe side-effects."

The consultant psychiatrist, who is heading a team drawing up Government guidelines on the treatment of ADHD, said: "Everyone agrees that if there are alternatives we should be exploring these alternatives and looking at what psychological treatments can work and what helps the parents and the teachers."

The warnings come amid growing concern that ADHD is being diagnosed in children suffering from nothing more than natural boisterousness.

In March this year Dr Robert Spitzer, the U.S. psychiatrist who first identified the ADHD, admitted that up to a third of cases could have been misdiagnosed.

Tonight's Panorama also reveals disturbing evidence that other drugs, much more commonly used to treat ADHD, do not work in the long term.

A study in the U.S. suggests that while medication such as Ritalin and Concerta is effective initially, the effects wear off after three years of treatment.

The drugs, taken by around 55,000 British children at the cost to the NHS of £28million a year, stunt growth, the researchers discovered.

Many children take the controversial drugs for years at a time though they have also been linked to heart problems, dizziness and insomnia, and blamed for a string of deaths in the UK and abroad.

Researcher Professor William Pelham, of the University at Buffalo in New York state tracked the health and treatment of 600 children with ADHD for six years.

He warned: "They had a substantial decrease in their rate of growth, so they weren't growing as much as other kids in terms of their height and weight.

"In the short-run [medication] will help the child behave better, in the long-run, it won't. And that information should be made very clear to parents."

The makers of Concerta and Risperdal, Buckinghamshirebased Janssen-Cilag, said the drugs were "very valuable treatments".

Eli Lilly, the U.S.-based maker of Zyprexa, said it had never promoted the anti-psychotic for the treatment of ADHD and did not intend to do so.

The makers of Ritalin, Swissbased Novartis, were unable to comment last night. The Panorama programme will be shown on BBC1 at 8.30pm tonight.

Quote
Like
Share

Joined: April 1st, 2004, 4:56 pm

November 12th, 2007, 10:44 am #7

8,000 youngsters are taking anti- psychotics such as Risperdal and Zyprexa despite the fact that these have been linked to a host of health problems from diabetes to brain damage, BBC1's Panorama reports
Quote
Like
Share

Joined: April 1st, 2004, 4:56 pm

November 12th, 2007, 10:46 am #8


Dr Tim Kendall, of the Royal College of Psychiatrists, said he knew of children as young as ten being given the schizophrenia drugs for unruly behaviour, sometimes for as long as five years.

He said that the drugs should be considered as a last resort in the treatment of hyperactivity.

And he added: "A generous understanding would be to say that doctors have reached a point where they don't know what else to offer and they haven't got the right supports to help parents in difficult circumstances.

"I think perhaps there is no real excuse for prescribing drugs which are associated with such severe side-effects."
Quote
Like
Share

Joined: January 1st, 1970, 12:00 am

November 12th, 2007, 1:39 pm #9

<TABLE cellSpacing=0 cellPadding=0 width=629 border=0>
<TBODY>
<TR>
<TD colSpan=3>
<DIV class=mxb>

</DIV></TD></TR>
<TR>
<TD vAlign=top width=416><FONT size=2><!-- S BO --><!-- S IIMA -->
<TABLE cellSpacing=0 cellPadding=0 width=203 align=right border=0>
<TBODY>
<TR>
<TD>
<DIV><IMG height=152 alt="Craig Buxton aged 14" hspace=0 src="http://newsimg.bbc.co.uk/media/images/44229000/jpg/_44229996_craig2.jpg" width=203 border=0>
</DIV></TD></TR></TBODY></TABLE><!-- E IIMA --><!-- S SF -->Treating children who have Attention Deficit Hyperactivity Disorder with drugs is not effective in the long-term, research has shown.
A study obtained by the BBC's Panorama programme says drugs such as Ritalin and Concerta work no better than therapy after three years of treatment.
The findings by an influential US study also suggested long-term use of the drugs could stunt children's growth.
It said that the benefits of drugs had previously been exaggerated. <!-- E SF -->
The Multimodal Treatment Study of Children with ADHD has been monitoring the treatment of 600 children across the US since the 1990s.
'Exaggerated impact'
In 1999, it concluded that after one year medication worked better than behavioural therapy for ADHD.
This finding influenced medical practice on both sides of the Atlantic, and prescription rates in the UK have since tripled.
The report's co-author, Professor William Pelham of the University of Buffalo, said: "I think that we exaggerated the beneficial impact of medication in the first study.
"We had thought that children medicated longer would have better outcomes. That didn't happen to be the case.
"The children had a substantial decrease in their rate of growth so they weren't growing as much as other kids both in terms of their height and in terms of their weight.
"And the second was that there were no beneficial effects -none."
Video diary
Panorama said GPs in the UK prescribed ADHD drugs such as Ritalin and Concerta to around 55,000 children last year - at a cost of £28m to the NHS.
The Panorama programme features disturbing footage of a 14-year-old from Stoke-on-Trent, who has been on ADHD medication for a decade.
Craig Buxton's family kept a video diary of his behaviour and captured on camera examples of just how explosive his behaviour can be - he recently assaulted three school teachers.
His mother Sharon said things had gone from bad to worse.
"He has broke down and cried when he gets into situations," she said.
"He says: 'Why am I like this mum, I don't want to feel like this, I don't want to be like this, you know, help me'.
"And all I can do is go back to the doctors and say: 'Is there anything more you can do?'
"All they say is, well, we are doing what we can."
Panorama: What Next for Craig? BBC One 8.30pm, Monday 12 November 2007
</FONT></TD></TR></TBODY></TABLE>
http://www.socialaudit.org.uk/43739W.htm#Dear

Social Audit Ltd
P O Box 111 London NW1 8XG
Telephone/Fax 44 (0)171 586 7771

&nbsp;

Dr. Keith Jones, Chief Executive Officer&nbsp;
Medicines Control Agency&nbsp;
Market Towers, 1 Nine Elms Lane&nbsp;
London SW8 5NQ

23 November <STRONG><FONT size=4>1998
</FONT></STRONG>&nbsp;
&nbsp;

Dear Keith,

RITALIN AND NEUROLEPTIC WITHDRAWAL

Thank you for your letter of 20 November.

I was interested to hear of the stalwart diagnostic efforts of paediatricians, psychologists, child psychiatrists, teachers, parents and GPs in relation to ADHD and have no doubt this has contributed to the <STRONG>15-fold increase in Ritalin prescribing</STRONG>, over the past four years. <STRONG>I'm afraid what you said did nothing to muffle the extreme ringing of alarm bells, but I do accept that the terms of the Medicines Act 1968 critically limit your ability to question what is at the forefront of my mind. Where do teachers and parents get these ideas from, where does health come from, and what kind of a society are we clinging to</STRONG>?

I still can't work out whether the main question I asked about neuroleptic withdrawal is one for you or Professor Rawlins, but I've been waiting three months for an answer. To paraphrase: is it or is it `not acceptable that 13 out of 23 data sheets for neuroleptics do not warn prescribers that "withdrawal of drug treatment requires careful surveillance because the patient who appears well on medication may suffer a disastrous relapse if treatment is withdrawn inappropriately"? (BNF).

I was asking if you are satisfied? By saying you "will comment further, if necessary", when Tranter & Healy's paper is published, suggests to me either that you are satisfied, or that you entirely missed the question. I would not want to make a formal complaint of it without knowing which, though I think I might be entitled to either way.

The point of the question has nothing to do with the value of data sheets - I am sure most doctors ignore them. It is about the <STRONG>competence of the Licensing Authority</STRONG>, given that its role (in your own words) "<STRONG>is to provide information to the prescriber about the safe use of a medicine by means of the authorised product information, in order that they make take this into account when making prescribing decisions</STRONG>".

Thank you, in advance, for your most focused attention.

Yours sincerely,&nbsp;
Charles Medawar "

&nbsp;
Quote
Like
Share

Joined: January 1st, 1970, 12:00 am

November 12th, 2007, 2:11 pm #10

<TABLE cellSpacing=0 cellPadding=0 width=629 border=0>
<TBODY>
<TR>
<TD colSpan=3>
<DIV class=mxb>

</DIV></TD></TR>
<TR>
<TD vAlign=top width=416><FONT size=2><!-- S BO --><!-- S IIMA -->
<TABLE cellSpacing=0 cellPadding=0 width=203 align=right border=0>
<TBODY>
<TR>
<TD>
<DIV><IMG height=152 alt="Craig Buxton aged 14" hspace=0 src="http://newsimg.bbc.co.uk/media/images/44229000/jpg/_44229996_craig2.jpg" width=203 border=0>
</DIV></TD></TR></TBODY></TABLE><!-- E IIMA --><!-- S SF -->Treating children who have Attention Deficit Hyperactivity Disorder with drugs is not effective in the long-term, research has shown.
A study obtained by the BBC's Panorama programme says drugs such as Ritalin and Concerta work no better than therapy after three years of treatment.
The findings by an influential US study also suggested long-term use of the drugs could stunt children's growth.
It said that the benefits of drugs had previously been exaggerated. <!-- E SF -->
The Multimodal Treatment Study of Children with ADHD has been monitoring the treatment of 600 children across the US since the 1990s.
'Exaggerated impact'
In 1999, it concluded that after one year medication worked better than behavioural therapy for ADHD.
This finding influenced medical practice on both sides of the Atlantic, and prescription rates in the UK have since tripled.
The report's co-author, Professor William Pelham of the University of Buffalo, said: "I think that we exaggerated the beneficial impact of medication in the first study.
"We had thought that children medicated longer would have better outcomes. That didn't happen to be the case.
"The children had a substantial decrease in their rate of growth so they weren't growing as much as other kids both in terms of their height and in terms of their weight.
"And the second was that there were no beneficial effects -none."
Video diary
Panorama said GPs in the UK prescribed ADHD drugs such as Ritalin and Concerta to around 55,000 children last year - at a cost of £28m to the NHS.
The Panorama programme features disturbing footage of a 14-year-old from Stoke-on-Trent, who has been on ADHD medication for a decade.
Craig Buxton's family kept a video diary of his behaviour and captured on camera examples of just how explosive his behaviour can be - he recently assaulted three school teachers.
His mother Sharon said things had gone from bad to worse.
"He has broke down and cried when he gets into situations," she said.
"He says: 'Why am I like this mum, I don't want to feel like this, I don't want to be like this, you know, help me'.
"And all I can do is go back to the doctors and say: 'Is there anything more you can do?'
"All they say is, well, we are doing what we can."
Panorama: What Next for Craig? BBC One 8.30pm, Monday 12 November 2007
</FONT></TD></TR></TBODY></TABLE>

<DIV><FONT face=Arial size=2>
<TABLE cellSpacing=0 cellPadding=0 width=416 border=0>
<TBODY>
<TR>
<TD vAlign=top><A onclick="javascript:newsi.utils.av.launch({el:this});return false;" href="http://www.bbc.co.uk/mediaselector/check/player/nol/newsid_7090000/newsid_7090000?redirect=7090066.stm&news=1&bbwm=1&nbwm=1&bbram=1&nbram=1&asb=1"><IMG height=152 alt="Generic drugs " hspace=0 src="http://newsimg.bbc.co.uk/media/images/44233000/jpg/_44233024_drugs203.jpg" width=203 align=left border=0></A></TD>
<TD><IMG height=10 alt="" hspace=0 src="http://newsimg.bbc.co.uk/shared/img/o.gif" width=10 align=left border=0></TD>
<TD vAlign=top width=203>

<A onclick="javascript:newsi.utils.av.launch({el:this});return false;" href="http://www.bbc.co.uk/mediaselector/check/player/nol/newsid_7090000/newsid_7090000?redirect=7090066.stm&news=1&bbwm=1&nbwm=1&bbram=1&nbram=1&asb=1"><IMG height=13 alt="" hspace=0 src="http://newsimg.bbc.co.uk/nol/shared/img/v3/icons/video_text.gif" width=57 align=left border=0></A>
</TD></TR></TBODY></TABLE></FONT><FONT face=Arial size=2></FONT></DIV>
<DIV><FONT face=Arial size=2></FONT>&nbsp;</DIV>
<DIV><FONT face=Arial size=2></FONT>&nbsp;</DIV>
<DIV><FONT face=Arial size=2><A id=s0 title="Play this media link" href="http://news.bbc.co.uk/player/nol/newsid_7090000/newsid_7090000/7090066.stm?bw=bb&mp=rm&asb=1&news=1&ms3=52#">Drugs may not help ADHD</A>
<DIV class=show id=s0_content><!-- S BO -->Using drugs to treat children who have Attention Deficit Hyperactivity Disorder is not effective in the long-term, research has shown.
More on this story can be seen in Panorama: What Next for Craig? BBC One 8.30pm, Monday 12 November 2007 </FONT>
</DIV></DIV>
<DIV><FONT face=Arial size=2>http://news.bbc.co.uk/player/nol/newsid_7090000/newsid_7090000/7090066.stm?bw=bb&mp=rm&asb=1&news=1&ms3=52</FONT></DIV>
<DIV><FONT face=Arial size=2></FONT>&nbsp;</DIV>
<DIV><FONT face=Arial size=2></FONT>&nbsp;</DIV>
<DIV><FONT face=Arial size=2></FONT>&nbsp;</DIV>
<DIV><FONT face=Arial size=2></FONT>&nbsp;</DIV>
<DIV><FONT face=Arial size=2>Gotta go.</FONT></DIV>
Quote
Like
Share